Pengaruh karakteristik pasien dan persepsi tentang mutu pelayanan terhadap pulang atas permintaan sendiri di Rumahsakit Paru Dr. Ario Wirawan Salatiga

PRABOWO, Bambang, dr. Tjahjono Kuntjoro, MPH.,DrPH

2004 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Idealnya, pasien yang dirawat di rumah sakit pulang setelah diijinkan oleh dokter yang merawat. Tetapi pada kenyataannya di Rumah Sakit Paru Dr. Ario Wirawan Salatiga ditemukan pasien pulang atas permintaan sendiri. Tujuan dari penelitian ini, adalah ingin mengetahui ada tidaknya pengaruh karakteristik dan persepsi pasien terhadap kecenderungan untuk pulang atas permintaan sendiri. Karakteristik pasien yang meliputi jenis kelamin, umur, pendidikan, asal daerah, pekerjaan, lama perawatan dan diagnosis penyakit, serta persepsi terhadap pelayanan. Metode: Penelitian ini dilakukan di Rumah Sakit Paru Dr. Ario Wirawan Salatiga pada bulan Desember 2003 sampai dengan Februari 2004. Data dikumpulkan dari 470 respoden terdiri dari 89 pasien pulang atas permintaan sendiri dan 381 pulang ijin dokter. Penelitian ini adalah kuantitatif dengan didukung kualitatif. Data diambil secara cross sectional dan diolah dengan analisis analisis univariat, uji chi square dan resiko relatif. Persepsi terhadap mutu pelayanan dipakai metode Servqual. Hasil: Dari uji statistik, nilai chi-suare pekerjaan 9,361, nilai chi square pendidikan 0,394, nilai chi-square lama dirawat 9,156 dan asal daerah dengan nilai 35,958 kelas perawatan 7,348. Jenis kelamin mempunyai nilai chi-square 2,948, nilai umur 16,121 dan nilai diagnosis penyakit 0,068. Servqual hanya mempunyai pengaruh 1% terhadap pasien pulang atas permintaan sendiri, sedangkan 99% disebabkan oleh faktor lain. Kesimpulan: Faktor-faktor yang berhubungan dengan pasien pulang atas permintaan sendiri adalah pekerjaan, asal daerah, lama dirawat dan kelas perawatan. Faktor-faktor yang tidak berhubungan dengan pasien pulang atas permintaan sendiri adalah jenis kelamin, pendidikan, umur dan diagnosis penyakit. Persepsi pasien pulang ijin dokter maupun pulang atas permintaan sendiri terhadap mutu pelayanan, adalah sama. Kedua kelompok ini menyatakan bahwa pelayanan yang diterima belum sesuai harapan mereka

Background: Ideally, patients who are treated in the hospital, when they are discharge from the hospital should be based on doctor’s permission. But, in fact, in Dr. Ario Wirawan Pulmonary Hospital Salatiga, there had patients who were discharge from the hospital against medical advice. The aim of this research was to find out factors that had relationship with patients discharge against medical advice. The related factors were patient’s characteristics that consist of sex, age, education, job, length of stay and diagnosis of disease as well as questioner distribution. Method: This research was located in Dr. Ario Wirawan Pulmonary Hospital Salatiga. The design of this research was quantitative and qualitative back up, and consumer’s satisfaction instrument was used to find out respondent’s perception toward the service. Data was taken with cross sectional toward all patients who were discharge from hospital in the period of December 2003 to February 2004. The collected data was 470 respondents with details of 381 based on doctor’s permission and 89 discharge against medical advice. It was analyzed with univariat and chi square statistic and also relatif risk analysis. While, for perception toward the service, Servqual method was used. Result: The statistic test obtained that job had chi square value of 9,361, value of education is 0,394, value of length of stay is 9,156, value of patient’s come from is 35,958, value of treatment class is 7,348 , sex had chi square value of 2,948, age had chi square value of 16,121, and diagnostic of the disease had chi square value of 0,068 . Servqual had influence 1% toward patients discharge against medical advice, while 99% based on other factor. Conclusion: From the statistic test, factors that had relationship with patients discharge against medical adviced were job, patient came from, length of stay and class of treatment. On the other hand, factors that did not related were sex, age, education and diagnostic of the disease. For the measurement toward service quality, patients who were discharge based on the permission of doctor or based on personal request had the same perception. Both of the groups mentioned that the obtained service was not yet fulfilled their expectation.

Kata Kunci : Manajemen Rumah Sakit,Persepsi Pasien,Mutu Layanan,Pulang Permintaan Sendiri,patients discharge against medical adviced , patient’s characteristic, servqual